Techniques for Managing the Airway

Abstract

Most if not all sedation medications negatively affect the patency of the airway, most commonly secondary to soft tissue obstruction, although central apnea may also occur. The techniques available for managing the pediatric airway during sedation are myriad, and deciding which one to use depends on a variety of considerations. These include factors such as the level of sedation required for the procedure, the anticipated duration of the procedure, the remoteness of the patient from the provider, the child’s medical condition, and any airway conditions the child may have. The overarching goal is to maximize the child’s safety and mitigate the risk of airway consequences that the sedation may pose. This section discusses effective positioning, oxygen administration, chin left, jaw thrust, and use of oropharyngeal and nasopharyngeal airways, along with laryngeal mask airway placement and (briefly) endotracheal intubation.